Provider Demographics
NPI:1164511416
Name:MEREL, GARY
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:MEREL
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:GARY
Other - Middle Name:
Other - Last Name:MEREL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS LAC
Mailing Address - Street 1:6928 N MEADOWS PASS
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-8639
Mailing Address - Country:US
Mailing Address - Phone:734-222-8210
Mailing Address - Fax:
Practice Address - Street 1:210 LITTLE LAKE DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6218
Practice Address - Country:US
Practice Address - Phone:734-222-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000622171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist